Munchausen syndrome by proxy

Abstract

This review deals with bibliography on Munchausen syndrome by proxy (MSbP). The name of this disorder was introduced by English psychiatrist Roy Meadow who pointed to diagnostic difficulties as well as to serious medical and legal connotations of MSbP. MSbP was classified in DSM-IV among criteria sets provided for further study as "factitious disorder by proxy", while in ICD-10, though not explicitly cited, MSbP might be classified as "factitious disorders" F68.1. MSbP is a special form of abuse where the perpetrator induces somatic or mental symptoms of illness in the victim under his/her care and then persistently presents the victims for medical examinations and care. The victim is usually a preschool child and the perpetrator is the child's mother. Motivation for such pathological behavior of perpetrator is considered to be unconscious need to assume sick role by proxy while external incentives such as economic gain are absent. Conceptualization of MSbP development is still in the domain of psychodynamic speculation, its course is chronic and the prognosis is poor considering lack of consistent, efficient and specific treatment. The authors also present the case report of thirty-three year-old mother who had been abusing her nine year-old son both emotionally and physically over the last several years forcing him to, together with her, report to the police, medical and educational institutions that he had been the victim of rape, poisoning and beating by various individuals, especially teaching and medical staff. Mother manifested psychosis and her child presented with impaired cognitive development, emotional problems and conduct disorder.

Medicolegal characteristics of domestic violence

“…These results correspond with the findings of other researchers that also suggested the high number of under-reported cases of DV against children [18]. The explanation for this phenomenon lies in a child's total dependence on their abusive parents, who, logically, avoid self-reporting to the authorities [19,20]. In our study, a non-violent parent (usually also a victim of the same abusive family member) has always reported DV against children.…”

“…In our study, a non-violent parent (usually also a victim of the same abusive family member) has always reported DV against children. In accordance with these results, appropriate national strategies are required for the disclosure of DV and child protection [18,19,20].…”